卵巢癌MDR1基因表达与近期化疗效果

EXPRESSION OF MDR1 GENE IN HUMAN OVARIAN CARCINOMA AND CHEMOTHERAPEUTIC OUTCOME

目的 研究卵巢癌ＭＤＲ１ 基因表达对化疗的影响。 方法 应用免疫组织化学（ＡＢＣ） 法及改进的逆转录聚合酶链反应（ＲＴＰＣＲ）分别检测ＰＧＰ和ＭＤＲ１ 基因ｍ ＲＮＡ 的表达水平。 结果 ４９ 例卵巢癌中用ＡＢＣ法检测ＰＧＰ表达的阳性率为４２８％ ，其中有化疗史的阳性率为３６０％ ；无化疗史的为５００ ％ （ Ｐ＞ ００５）。ＰＧＰ染色阴性的近期化疗有效率为５３６ ％ ，而染色阳性的为１４３ ％ （Ｐ＜ ００５） 。有３７ 例卵巢癌用改进的ＲＴＰＣＲ 检测ＭＤＲ１ 基因ｍ ＲＮＡ 表达的阳性率为７０３ ％ 。有化疗史的阳性率为９５２％ ；而无化疗史的阳性率为３７５ ％（ Ｐ＜０００１） 。ＭＤＲ１ 基因ｍＲＮＡ表达阴性的近期化疗有效率为８１８ ％ ，而表达阳性的为２３１％ （Ｐ＜ ０００５）。此同样３７ 例卵巢癌免疫组化结果并未见与化疗史相关，但仍发现与近期疗效存在相关性。 结论 ＭＤＲ１ 基因表达与卵巢癌化疗密切相关，ＰＧＰ／ ＭＤＲ１ ｍＲＮＡ 有可能作为预测卵巢癌化疗效果的一项指标。改进ＲＴＰＣＲ 方法适用于临床耐药性检测。

To study the relationship between expression of MDR1 gene and response to chemotherapy.METHODS P GP and MDR1 mRNA levels were measured by immunohistochemistry ABC and RT PCR assay in ovarian carcinoma.RESULTS The expression rate of P GP staining in 49 cases was 42.8%.In cases with chemotherapy,the positive rate was 36.0%,but without it ,the positive rate was 50.0%( P >0 05). In cases with P GP negative staining, the immediate effective rate was 53.6%,but in the positive cases it was 14.3%( P <0 05). The positive rate of MDR1 mRNA was 70.3% with improved RT PCR in 37 among 49 cases of ovarian carcinomas.In cases with history of chemotherapy the positive rate was 95.2%,but without it ,the positive rate was 37.5%( P <0 001).In cases with negative MDR1 mRNA,the immediate effective rate was 81.8%,but in positive those,it was 23.1%( P <0 005).P GP staining was correlated to immediate effectiveness of chemotherapy,but not with chemotherapy history in the same 37 ovarian carcinomas which were measured by immunohistochemistry ABC assay.CONCLUSIONS The overexpression of MDR1 gene was closely correlated to acquired drug resistance in patients with ovarian carcinoma.The level of MDR1 mRNA/P GP may be an index for predicting chemotherapeutic outcome.Improved RT PCR techniques can be used to detect drug resistance clinically.